Water, Sanitation and Hygiene

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1 Water, Sanitation and Hygiene UNICEF/Giacomo Pirozzi for children unite for children

2 UNICEF/Julie Pudlowski Fast facts Tanzanians that lack access to improved drinking water sources 46% Tanzanians with no access to improved sanitation 87% Population who wash hands with soap before preparing food 20% Schools with no water supply in the school premises 38% Schools with no functional hand washing facilities 84% Schools with no doors on girls latrines 52% Schools with no sanitary facilities suitable or 96% accessible to children with disabilities Average pupils/latrines drop hole in public and private primary 56 schools nationwide Average pupil/latrine ratio in government primary schools 215 boys/187 girls in Dar es Salaam Source: School WASH Mapping in 16 districts, by SNV, WaterAID, UNICEF (2009); TDHS 2010; BEST 2010 why WASH matters UNICEF/Sala Lewis Up to one third of deaths in children underfive years in Tanzania are related to poor hygiene. This includes nearly 20 per cent of under-five deaths due to preventable diarrhoea, as well as deaths among newborns and due to respiratory illness. Hand washing with soap, alone, has the highest impact on reducing disease transmission, including diarrhoea, lowering the condition by about 47 per cent. However, awareness about the importance of hygiene practices, especially hand washing with soap, is low. Sanitation has the second highest impact on reducing diarrhoea, decreasing the impact by about 36 per cent. Nevertheless, access to safe drinking water and to improved toilets that can be kept clean continues to constrain Tanzania s ability to adequately address the under-five child mortality rate.

3 a clean environment for children Children spend a significant amount of time in and around their schools. Inadequate water supply and sanitation facilities, not only are a health hazard, but also affect school attendance, retention and educational performance. Yet these invaluable commodities are not available to many Tanzanian school children. Water, sanitation and hygiene (WASH) facilities in Tanzania s schools are extremely poor. The rapid increase in primary school enrolment since the abolition of school fees for primary education in 2002 has put a heavy burden on existing school infrastructure and particularly on WASH facilities. Many new schools and classrooms are built with no consideration for WASH facilities or if built, these rarely follow any standards. National data shows that on average there is only one pit latrine for every 56 children in primary schools (both public and private), yet there are sharp regional differences and differences between government and private schools. Government primary schools in Dar es Salaam, the nation s largest city, are especially poorly served with Ministry of Education data showing only one latrine for 215 boys and 187 girls. A detailed 2009 study supported by UNICEF and other partners that covered all schools in 16 districts showed that over 80 per cent of schools lacked functioning hand-washing facilities, and virtually none had any soap available. Only four per cent of schools had made any sanitation or hand-washing provision for children with disabilities. Schools where water and sanitation facilities lack privacy, are unsafe, or are non-existent, usually have the poorest attendance records and highest drop-out rates. Improving WASH in schools is essential for keeping girls in school, and ensuring their right to education. After reaching puberty, girls in particular are less likely to regularly attend school if toilet and hygiene facilities are inadequate. Children in such schools also face increased health risks including diarrhoea, worms and urinary infections - which can impact their ability to learn and could result to increased absenteeism. Poor attendance often translates into poor performance, and students who perform poorly are more likely to drop out early from school. UNICEF/Giacomo Pirozzi

4 UNICEF/Giacomo Pirozzi what is UNICEF doing UNICEF is a leading advocate for child rights in Tanzania. Our equity-based approach emphasises the rights of all children, including those with disabilities, to access water and sanitation services necessary to their survival, growth and development, at school and at home. Given the enormous challenges in the country, UNICEF focus in WASH centres on collaboration with partners and the Government to develop national sustainable solutions for delivering WASH at scale in Tanzania s schools. Scaling up WASH in schools Four Ministries are responsible for ensuring delivery of WASH in schools: the Ministry of Health and Social Welfare, Ministry of Education and Vocational Training, Ministry of Water and the Prime Minister s Office-Regional Administration and Local Government. Systematic cooperation and collaboration between these ministries is vital for assuring sustainable solutions to WASH in schools. UNICEF played a key role in supporting the development of Memorandum of Understanding between these ministries which defines a framework for cooperation and relative responsibilities. UNICEF assisted development of the draft National Sanitation and Hygiene Policy which reflects joint commitment by these government bodies responsible for different aspects of WASH in Schools. Collaboration between the four ministries was also critical for the development of harmonized set of National School WASH Guidelines and Toolkits for Tanzania. UNICEF ensured that the guidelines are suitable for the needs of all girls and boys, including children with disabilities, and that they promote sustainable solutions to suit different environments. The guidelines and toolkits include Hygiene Education and Promotion, including menstrual Hygiene Management for Adolescent Girls, maintenance of water and sanitation facilities, mobilising community commitments etc. Children can be the most effective advocates for social and behaviour change. Part of the whole school package for WASH supported by UNICEF includes the establishment of hygiene and sanitation clubs where pupils learn healthy practices and are encouraged to pass on these life-saving sanitation and hygiene practices to family members - both adults and younger siblings - and thereby positively influence the community as a whole. Resource mobilization for school WASH The School WASH guidelines are being modelled in around 50 schools by UNICEF and partners, providing a safe learning environment for about 25,000 children. Experience from the piloting will create a tested model for the School WASH package which will be used to help drive the major investments needed to ensure minimum water, sanitation and hygiene standards in Tanzania s schools. It is estimated that providing WASH facilities in all 18,000 primary schools of Tanzania, reaching over 10 million school children, will require an investment of about $450 million. Leveraging the significant investments needed in the sector is a primary goal for UNICEF. Addressing Household Sanitation, Hygiene and Water Quality Challenges Tanzania is facing a sanitation crisis. Nearly 5 children die every hour due to poor hygiene and sanitation. More than 42 million people use unsanitary (unimproved) latrines and a further 5 million people practice open defecation. UNICEF is collaborating with government on a standard household package including access to improved sanitation facilities, hygiene promotion with focus on

5 hand-washing with soap and promotion of household water treatment and storage. In close collaboration with other sector partners, UNICEF is helping the Ministry of Health and Social Welfare to formulate a national sanitation plan with clear targets, timelines and funding requirements. According to the 2010 Tanzania Demographic Health Survey, around 60 per cent of households in Tanzania do not treat their water before drinking. UNICEF is supporting a comprehensive national study on treatment practices in Tanzania with a consortium of international and national academic institutions. Evidence from the research will guide the government to develop an action plan to improve water treatment and storage at household level and reduce diarrhoea and other diseases associated with unsafe drinking water. Household Water Treatment and Safe Storage is a cheap and effective strategy for water treatment. However, householders must have the motivation to treat their drinking water and the technologies and consumables must be affordable and easily available. WASH in emergencies Emergencies, be they rapid onset, chronic, natural or man-made, inevitably cause disruption to basic services. People are less likely to be able to drink safe water, use basic sanitation facilities and maintain improved hygiene practices. Children, especially those under the age of five, are particularly vulnerable to the diseases which can result during emergencies. These diseases include diarrhoea, cholera, respiratory infections, which are all linked when water supplies and sanitation services are disrupted. UNICEF maintains stocks of supplies (buckets, soap and jerry cans) in strategic locations to permit timely response during emergencies for at least 20,000 people. In addition, UNICEF contributes a pivotal role in convening the Emergency WASH Preparedness and Response meetings that, among others, seek to better prepare all sector actors to respond to emergencies. Impact with equity Within the framework of the United Nations Development Assistance Plan ( ) in Tanzania, UNICEF s contribution is strategic and focused on UNICEF s comparative advantage in addressing sustainably capacity gaps in the WASH sector. Support will be provided to the Government to ensure a coordinated and harmonized response for increased coverage and improved equity and quality of appropriate School WASH facilities for all children, and an equitable national scaled up response for improved Sanitation and Hygiene. helping girls to learn about themselves UNICEF/Julie Pudlowski Adolescent girls are especially vulnerable to dropping out as many are reluctant to continue their schooling because toilet and washing facilities are not private, not safe or simply not available. When schools have adequate facilities in particular ones that facilitate menstrual hygiene a major obstacle to attendance is removed. In recognition of the apparent lack of information provided to young girls around the issue of menstruation, an educational booklet was put together for Tanzanians entitled Vipindi vya Maisha or Growth and Changes. The development of this booklet followed participatory research conducted with girls on menstruation. It provides basic information on menstruation and hygiene, clarifying myths and taboos that often surround the topic. It includes stories written by Tanzanian girls about their first experiences of menses, basic puberty guidance, and an activity section that includes frequently asked questions. It also teaches girls to track monthly menses on a calendar so they can always be prepared. Widespread distribution of the booklet will help to empower girls with knowledge, help to increase their self-esteem and ultimately their school attendance. The hope is that empowered adolescent girls will also help their female relatives at home and in the community to deal better with menstruation issues. UNICEF has supported distribution of the booklet to over 50,000 girls in four districts. The aim is to make the booklet available on a national scale.

6 Safe drinking water and adequate sanitation are crucial for poverty reduction, for sustainable development, and for achieving any and every one of the Millennium Development Goals. UN Secretary-General, Ban Ki-moon key results for water, sanitation and hygiene by 2015 Supporting key ministries departments and agencies to develop a resource mobilization strategy for School WASH to ensure sustained availability of resources and provide Water, Sanitation and Hygiene in all schools of Tanzania, including the most under-served areas. Providing direct support to enable over 40,000 children to obtain equitable access to water, sanitation and hygiene services in their schools. Supporting roll out and operationalisation of School WASH guidelines and development of monitoring system to ensure all schools in the country are implementing the same School WASH Standards; Development of School WASH guidelines for Zanzibar. Collaborating with partners, other development partners and implementation of a national communication and advocacy strategy for School WASH. Ensuring a harmonized approach for sanitation and hygiene and national dissemination of the Sanitation and Hygiene policy. Supporting development of health promotion strategies and implementation of evidence based communication programmes relating to WASH behaviours. Supporting improved sector governance. Advocating and supporting the reduction of sector disparities. Pre-positioning of essential WASH emergency supplies in strategic locations for rapid deployment during emergencies, including emergency IEC materials. funding gap (USD) Programme intervention Funds required Funding gap School WASH 5,400,000 4,000,000 Sanitation and Hygiene 7,200,000 4,800,000 WASH evidence and equity 2,400, ,000 WASH in emergencies 3,600,000 1,300,000 Total Water, Sanitation and Hygiene programme 18,600,000 10,600,000

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